Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $177.83	Professional		$20.89	$32.36	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.90 / $72.44	Professional		$36.31	$38.90	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $58.88	Professional		$26.92	$40.74	$58.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $52.48 / $95.50	Facility		$30.20	$52.48	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $53.70 / $85.11	Professional		$30.20	$53.70	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $33.11	Professional		$20.89	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $77.62 / $79.43	Facility		$58.88	$77.62	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $83.18 / $97.72	Professional		$33.88	$83.18	$97.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $38.90	Professional		$28.84	$33.88	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $57.54 / $107.15	Professional		$35.48	$57.54	$107.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81